HomeMy WebLinkAboutStreet Cut Permits 140 Nutmeg Road (2) 1600219 TOWN OF ,SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
DATE: 11/23/2016
GIS ID:65100140 t FEE: 25.00
MUNIS APPLICATION# 201601750 $ *EXPIRATION DATE: 1 i/23/2017
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APPLICANtt s, S �` LOCATION
NAME: INCORPORATED INDUSTRIES,LLC AbbRE S �I4.6N`1 TMEG ROAD
ADDRESS: 180 W NEWBERRY JR6 5 s ,1WN R 5 t 00L Y REALTY LLC
BLOOMFIELD,CT 06' 2 14Q 7U MEG DR
Y r TSOUT 45WINDSOR CT 06074
PHONE 860-242-0150
WORD DESCRIPTION: CODE 1�kt1._.A1till
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APPLICANT AGREES TO FURNISH TH ,iTO WN CIFOT fz4I�IDSR,T D REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR AI*IY I XP TS) S I1*1GUMD i5THE TQWNYI C�R'VIAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND TI'' CANT,IS FAIR UnITHNIS�VUT L IDR BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOW1V'OF S0 7fiI WII+ID�OIt'S STR>r T C�7T T' I MIT MANUAL.
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ISSUED BY DATP INPECTED INSPECTED BY
I]/23/201612:32PM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO:: 16 22 r CONTRACTOR:
LOCATION: qd c) -r rp
TYPE OF WORK: U
DATE INSP NEEDED: DATE INSP: izLx .�'i
INSPECTED BY:
WORK IN
PROGRESS;
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SEPTIC TANK PUMPED--,SMASHED, FILLED WITNESSED ❑YES ❑ NO
AS-BUILT: •
INPUT: DATE:
s/mouoy/Pornfs=4 Town of south Windsor ImEamwREPORT 14
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
PUBLIC WORKS DEPARTMENT
TOWN HALL
1540 SULLIVAN AVENUE
SOUTH WINDSOR, CT
FEE $60.00
Location of proposed work: /y� � / f Lot #
Street No. Street Name
Premises owned by: • � h / �leh
Name of Firm: f�Cr7I Sri l�� r L Phone:
Address of Firm:
TYPE OF WORK: Y��a, F�- GJ / LJ Fc7tf 1Qf2yEffi�/
Lay House Drain ; Repair House Drain V ;
Lay Main ; Lay Lateral for Commercial/Industrial
Building of acres
Connection will be made with
Existing Water Supply: Public Wafter Well
Proposed Start Date a Estimated time for completion
ALL WORK TO BE IN ACCORDANCE WITH TOWN OF SOUTH WINDSOR STANDARDS,
ALL OSHA REQUIREMENTS AND CONDITIONS ATTACHED TO THE PERMIT
Permit is to be issued to � r the holder of Drain
Layer's License No. 2o-S d6 r P,_� Only holders of P-1, P-7 or W-9 licenses
will be issued a permit. PERMIT WILL EXPIRE THIRTY(30) DAYS AFTER
DATE OF ISSUANCE. The undersigned Drain Layer hereby agrees.to all the terms
and conditions set forth in the permit and attached thereto. Applicant has received
Town Street Excavation Permit No. and/or ConnDOT Permit No.
CBYD No. PLEASE NOTE:
IF A SANITARY SEWER LATERAL
IS WITHIN 75 FEET OF A WELL
IT MUST BE AIR TESTED
Signed. Print Name: O�
Licensed Drain Layer
Date:_ 2 Z 116
Standard Forms\Permits\APPUCATION FOR DRAIN LAYERS PERMrT doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: ` "
BUILDING ADDRESS : I ®
STREET : Atdr-W& ESA
SUBDIVISION: POWrAg5 C A/ L',0
NORTH ARROW
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CONTRACTOR (PRINT) NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
STREET ADDRESS SIGNATURE
41'u v. �`�=I _ C- I G 6 v L ,2�1 DATE
TOWN STATE ZIP INSPECTED BY TOWN
_�b 6) ()ISO DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER